钩钢板侧块螺钉内固定在治疗寰枢椎脱位中的应用

The Clinical Aplication of Hook Plate Lateral Mass Screw Fixation in Atlantoaxial Dislocation

目的通过对寰枢椎脱位患者行后路钩钢板侧块螺钉内固定的治疗及术后随访,探讨钩钢板侧块螺钉内固定在寰枢椎脱位后路固定手术的操作方式、注意问题及临床疗效。方法通过对2001年4月至2008年8月收治的8例寰枢椎脱位患者行后路钩钢板侧块螺钉内固定治疗,术后随访7～95个月不等,对患者的症状改善情况、骨性融合情况进行分析,以探讨该手术方式的可行性及临床效果。结果 8例患者手术过程顺利,未发生脊髓、神经根、椎动脉等重要解剖结构的损伤;后路手术出血量100～200 mL,平均出血量140 mL,手术时间170～220 min;术后脊髓功能均获得改善,肢体麻木、无力症状减轻;未出现内固定松动、断钉及再脱位情况,全部患者获得骨性融合;术后未出现头晕头痛等脑缺血症状及与该手术操作可引起的其他相关症状。结论对可复性寰枢椎脱位采用后路钩钢板侧块螺钉内固定治疗是可行、安全、有效的。

Objective By atlantoaxial dislocationpatients with posterior hook plate for lateral mass screw fixation and postoperative follow-up presentation to explore the hook plate for lateral mass screw fixation in atlantoaxial dislocation posterior fixation of the mode of operation,notice and clinical efficacy.Methods By follow-up 8 case of atlantoaxial dislocation patients for 7～95 months who have being used hook plate lateral mass screw fixation for therapy,we studied on the operation mode,attention problems and clinical effect of hook plate lateral mass screw fixation.Results The result of the 8 patients who had been used hook plate lateral mass screw fixation for therapy：None case has injury of spinal cord or vertebral artery or other important structure.The blood loss was from 100～200 mL in operation.The operation time was 170～220 min.All of patients have improving in spinal function;the symptoms such as limb numbness,asthenia has alleviated.None of them has internal fixation loosening,nail broken or redislocation.All of them abtained bone union and none of them has onset of symptoms such as dizziness headache and so on which has relation with this therapy.Conclusions In therapy of recoverability atlantoaxial dislocation,the hook plate lateral mass screw fixation is practicable,safe and effective.